My goal in publishing TCPR is to help you think differently about your clinical practice, hopefully to enhance your effectiveness as a healer. After editing this month’s issue on posttraumatic stress disorder (PTSD), I think I’ve achieved that goal in my own practice.

Every five years or so, we do an update on PTSD treatments; the most recent was our August 2011 issue of TCPR, in which we declared that psychotherapy was the gold standard for treatment.

While I appreciate all of my TCPR subscribers, there’s one subscriber whom I value above all the others: my father. A psychiatrist who practices in the Bay Area, my father has been a loyal subscriber since Volume 1, Number 1, in January of 2003.

A welcome note from Editor-in-Chief and Publisher Daniel Carlat, MD, and a list of take home points from related to this special double issue.

Kratom (Mitagyna speciose) is a tropical evergreen tree in the coffee family whose leaves have been used for centuries in South Asian countries as a stimulant and pain reliever. Recently, kratom has entered US and European markets and is now sold in various forms, both online and at local head shops.

Although studies have demonstrated the effectiveness of contingency management (CM) for illicit drug use, there’s less evidence for treatment of alcoholism—in part because a standard breathalyzer has a short detection window of 12 hours, meaning patients must only abstain from drinking since the previous night to pass the test.

NeuroStar just announced that the FDA has cleared an updated version of its TMS system. Called the NeuroStar Advanced Therapy System, its primary claim to fame is that patients can receive a full TMS treatment in only 19 minutes, as opposed to the 40 minutes required with NeuroStar’s original system.

We often prescribe antidepressants to patients who are suicidal, and unfortunately, some people use these very medications to try to kill themselves. It’s been known for some time that tricyclic antidepressants are among the most toxic in overdose, so we embraced the SSRIs and later medications in part because they are considered to be safer. But how safe are they?

PANS and PANDAS--a hitherto normal child suddenly develops severe OCD symptoms. These may include refusing to leave the house, engaging in constant checking and washing rituals, asking repeatedly if the door is locked, making odd facial movements, having full-on tantrums with kicking and screaming, wetting the bed, and being unable to perform in school. “I lost my child overnight” was, and is, a common refrain.

Do antidepressants cause bipolar II patients to switch from depression to hypomania? It’s a controversial question, and you’ll find academic psychiatrists who will argue passionately that antidepressants are either safe or dangerous in these patients. The latest study appears to endorse the “safe” camp.